A Systematic Review to Assess Swallowing Disorders in Paediatric Patients With Sleep-Disordered Breathing

Area of Science:

• Pediatric Pulmonology
• Pediatric Gastroenterology
• Speech-Language Pathology

Background:

• Sleep-disordered breathing (SDB) affects 5% of children and is linked to systemic issues.
• Concerns exist regarding potential links between obstructive SDB (oSDB) and swallowing dysfunction, especially after rare fatal choking incidents.
• This review excludes children with neurological or craniofacial conditions to focus on oSDB's direct impact on swallowing.

Purpose of the Study:

• To systematically review existing evidence on the association between pediatric obstructive sleep-disordered breathing (oSDB) and swallowing disorders.
• To identify the prevalence and nature of swallowing dysfunctions in children with oSDB.
• To assess the quality of evidence and identify gaps for future research.

Main Methods:

• A systematic literature search was performed across major databases (Embase, PubMed, CINAHL, Cochrane) following PRISMA 2020 guidelines.
• Studies included children with oSDB and swallowing assessments; exclusion criteria focused on non-English, syndromic, craniofacial conditions, and lack of primary data.
• Risk of bias was evaluated using the ROBINS-I tool.

Main Results:

• Nine studies met inclusion criteria, reporting swallowing dysfunction prevalence from 4% to 70%.
• Abnormalities were observed in both oral (e.g., atypical deglutition) and pharyngeal phases (e.g., choking, prolonged feeding).
• Evidence quality was low, with significant heterogeneity in assessment tools and study designs; only three studies suggested potential improvement after oSDB treatment.

Conclusions:

• Limited, low-quality evidence suggests a potential link between pediatric oSDB and swallowing dysfunction.
• Heterogeneity in studies hinders definitive conclusions, but clinicians should consider swallowing issues in affected children.
• Further research using standardized, objective assessments is crucial to clarify the relationship and inform clinical practice.